Nagi Talwinder K, Suarez Zoilo K, Haider Muhammad Adnan, Holder Shaniah S, Vallejo Charles, Chaudhari Sandipkumar S
Internal Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
Medicine, American University of Barbados School of Medicine, Bridgetown, BRB.
Cureus. 2023 Dec 11;15(12):e50324. doi: 10.7759/cureus.50324. eCollection 2023 Dec.
Per-oral endoscopic myotomy (POEM) is a minimally invasive procedure that is very effective in the treatment of achalasia, a rare esophageal motility disorder. POEM has become the first-line treatment for achalasia, with high success rates reported in the literature. However, a known complication of POEM is gastroesophageal reflux disease (GERD). The exact cause and risk factors of post-POEM GERD are not fully understood; however, a number of factors have played a role in its development. The management of post-POEM GERD is mainly by conservative measures, such as lifestyle changes and medications, like proton pump inhibitors (PPI), which are often the first-line method of treatment. However, surgical procedures, such as fundoplication, may be necessary in some patients. This literature review will discuss the effectiveness of the use of PPIs as a management strategy for post-POEM GERD, the factors that lead to PPI-resistant GERD, and other management strategies utilized in these cases.
经口内镜下肌切开术（POEM）是一种微创手术，对治疗贲门失弛缓症（一种罕见的食管动力障碍性疾病）非常有效。POEM已成为贲门失弛缓症的一线治疗方法，文献报道其成功率很高。然而，POEM的一个已知并发症是胃食管反流病（GERD）。POEM术后GERD的确切病因和危险因素尚未完全明确；然而，许多因素在其发生发展中起了作用。POEM术后GERD的治疗主要采用保守措施，如改变生活方式和使用质子泵抑制剂（PPI）等药物，这通常是一线治疗方法。然而，在一些患者中可能需要进行手术，如胃底折叠术。这篇文献综述将讨论使用PPI作为POEM术后GERD管理策略的有效性、导致PPI抵抗性GERD的因素以及在这些病例中使用的其他管理策略。
